Provider Demographics
NPI:1013783646
Name:RODRIGUEZ ESPINEL, GUSTAVO (EKG TECHNICIAN)
Entity type:Individual
Prefix:
First Name:GUSTAVO
Middle Name:
Last Name:RODRIGUEZ ESPINEL
Suffix:
Gender:M
Credentials:EKG TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 BROWN ST
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-2519
Mailing Address - Country:US
Mailing Address - Phone:925-575-3085
Mailing Address - Fax:
Practice Address - Street 1:414 BROWN ST
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-2519
Practice Address - Country:US
Practice Address - Phone:925-575-3085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAS7Y4Q6Q62472E0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG